- Poster presentation
- Open Access
Factors associated with poor outcome in right heart endocarditis
© Zamfira et al; licensee BioMed Central Ltd. 2013
- Published: 16 December 2013
- Public Health
- Internal Medicine
- Infectious Disease
- Urban Area
- Staphylococcus Aureus
We studied factors associated with poor outcome in right heart endocarditis.
In the period January 2011 – December 2012 at the National Institute for Infectious Diseases “Prof. Dr. Matei Balş” were admitted 53 patients with right endocarditis, with 72 episodes.
Males predominated (64.2%), patients in the age group 20-39 years (83%), those from urban areas (81%) and unemployed persons (69.8%). The infection was localized to the tricuspid valves – 42 cases, tricuspid valves plus left heart – 6 cases, right atrial wall – 3 cases, pulmonary valve – 1 case, right atrial device – 1 case. The main risk factor for right endocarditis was as IV drug use (86.8%). 87% of patients had HCV infection and 52.2% were HIV infected. Blood cultures were positive in 73.6% of cases. Staphylococcus aureus was the most frequently isolated (73.7%), type MSSA in 51.3% of cases.
Under treatment with antibiotics, anticoagulants, diuretics evolution was towards improvement in 52.8% of cases and 18.9% for death.
Factors associated with risk of poor outcome were: the presence of tricuspid murmurs (from 8/10 deaths vs. 13/43 survivors, p=0.003; OR=9.231, 95%CI: 1.719-49.55), the occurrence of embolic complications (4/10 deaths vs. 5/43 survivors, p=0.03; OR=5.067, 95%CI: 1.052-24.39), the presence of multiple pulmonary microabscesses (8/10 patients vs. 14/43, p=0.004; OR=8.286, 95%CI: 1.551-44.26), tricuspid vegetations larger than 10 mm (7/10 deaths vs. 5/43 survivors, p=0.0002; OR=17.73, 95%CI: 3.431-91.66), the association of HIV infection with elevated HIV-RNA and severe immune deficiency with CD4 below 200 cells/cmm.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.